Clients of Indoor Commercial Sex Workers: Heterogeneity in Patronage Patterns and Implications for HIV and STI Propagation Through Sexual Networks

Objectives: To determine whether "high-risk" clients occupied important sociometric positions in sexual networks of commercial sex workers and to estimate whether they were more likely to be HIV and STI infected. Goal: To determine whether a classification of high-risk clients could be validated by network analysis. Study Design: We used proxy data on clients collected from a cross-sectional survey of 49 indoor female sex workers. Results: Two types of clients were categorized as high risk, including those who created sexual bridges between sex establishments and those who had sex with most or all the FSW at an establishment. High-risk clients were significantly more central and were more likely to be members of cohesive subgroups than were lower-risk clients. The few known HIV and STI infections were in high-risk clients. Conclusions: It is possible to identify theoretically high-risk commercial sex clients from the network perspective using simple data collection and categorization approaches.